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S’pore ranked last among 33 developed nations with 220k residents per hospital while S.Korea has 12.4k per hospital

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Radar Healthcare, a UK company involved with safety in healthcare, published a survey in June this year to compare the healthcare systems of the 33 developed countries in the world.

Singapore was also included in the study.

Interestingly, it found that Singapore and Denmark have the lowest number of hospitals per 100 population ratio among the 33 first-world nations.

“We have Singapore and Denmark, which come in as the lowest-scoring countries for the number of hospitals vs population numbers, with 0.05% overall each,” Radar Healthcare said.

Radar Healthcare attributed Singapore’s low ratio to the very low amount of Singapore government’s spending on healthcare.

Indeed, according to data from the World Health Organization, Singapore pales in comparison with other first-world countries in terms of expenditure in the percentage of Gross Domestic Product (GDP).

South Korea, which was spending close to what Singapore was in 2000, ramped up its spending over 19 years and ended up spending 8.16 per cent of its GDP in 2019 while Singapore spent 4.08 per cent.

In the case of Denmark, it was due to the fact that the Danes focus on healthcare workers caring for patients in their homes rather than hospitals.

“The Danish Ministry of Finance wanted to focus on healthcare workers in patients’ homes rather than hospitals and that they were working on reducing the number of them to improve quality rather than quantity,” it added.

So, with 27 hospitals in Singapore, the ratio of population to hospitals is about 220,000 to 1.

The country that had the best number of hospitals compared to its population was South Korea, which has 4,133 hospitals to 51,329,899 people, or 12,400 people to 1 hospital.

“This left them with an overall percentage of 0.81%, highlighting that there are more than enough locations to treat sick people if needed,” Radar Healthcare said.

Japan came next with 15,100 population to 1 hospital. Radar Healthcare shared, “This is unsurprising, considering that Japanese citizens have a longer life expectancy compared to anybody else in the world, as their healthcare system is famous for focusing on preventative measures, rather than reactive ones.”

The third was Australia, with 19,500 population to 1 hospital. “The country focuses on a mix of private and public healthcare, which is a practice that is becoming more common across the globe – but it also relies on Medicare, which is a universal healthcare insurance scheme, paid for by the government and taxpayers,” commented Radar Healthcare.

The UK ranked 9th with 34,600 population to 1 hospital while the US ranked 13th with 54,500.

Severe Bed Crunch In Singapore

Recently, Straits Times reported that the bed crunch in public hospitals is so severe that it has spilled over to their emergency departments, many of which stay packed with patients because there is no room to move them elsewhere.

Emergency department (ED) doctors say there are days when the situation is so bad that an ambulance arriving is unable to discharge the patient for lack of space. Instead, the medical team has to assess the patients while they are on the ambulance trolley.

Minister of Health, Ong Ye Kung said in Parliament on Tuesday (8 Nov) that the bed crunch is about matching the demand and supply of hospital beds.

“The crowdedness and long waiting times for patients at the EDs in some hospitals, especially during a wave, is a manifestation of the problem of the mismatch of demand and supply of hospital beds,” said Mr Ong.

On the supply of hospitals in Singapore, Mr Ong gave three factors constraining the supply, and slowing down the process of warding ED patients.

  1. A secular trend of rising number of patients with long stays, which reduces the turnover of hospital beds. To illustrate, the percentage of patients who stay longer than 21 days has doubled from 1.6% of all hospitalised patients in 2019, to 3.8% in 2022.
  2. The pandemic caused construction disruptions which delayed the opening of healthcare facilities, namely the Woodlands Health Campus and the Integrated Care Hub at Tan Tock Seng Hospital. Construction delays due to the pandemic have also postponed the opening of several nursing homes and community day care facilities, and that also constrained the ability of hospitals to discharge less acute patients and free up hospital beds.
  3. As part of Singapore’s emergency planning, hospitals are required now to set aside or ringfence beds for the care of COVID-19 patients.

If one were to look at the number of beds available in Singapore, one would notice that there is a sharp increase in beds made available from 2011.

This can be attributed to the mad rush to build new hospitals over the past couple of years such as Ng Teng Feng Hospital, Sengkang Hospital and Jurong Community Hospitals and others.

Hospital Opened Beds Ownership
Mount Elizabeth Novena Hospital 2012 333 Private
Ng Teng Fong 2015 700 Public
Yishun Community Hospital 2015 224 Public
Jurong Community Hospital 2015 400 Public
Farrer Park Hospital 2016 121 Private
Sengkang General Hospital 2018 799 Public
Sengkang Community Hospital 2018 400 Public
Outram Community Hospital 2019 550 Public

Based on the data, we can see that most were built after 2011 — The year when the People’s Action Party lost its first Group Representation  Constituency (GRC) in Aljunied at the General Election.

Note that the increase in hospital beds in 2013 was due to the opening of a private hospital and not a public one.

Historically, it may also be interesting to note that the total number of hospital beds (public & private) dropped from 11,936 in 2001 to 11,394 in 2011 (Dept. of Statistics) – whilst the number of hospital admissions increased from 384,054 to 469,445 – medical tourists increased to 850,000 a year.

While the government is continuing the construction of more hospitals, the comparison with other first-world countries, both in spending and supply of hospitals, would suggest the authorities are playing catch-up with the supply of hospital beds.

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Editorial

Undying Phoenix: TOC navigates regulatory restrictions with a revamped approach

Despite new regulations hindering operations, The Online Citizen Asia (TOC) views this as a chance to return to its roots, launching Gutzy Asia for Greater Asian news, while refocusing on Singapore. Inviting volunteer support, TOC’s commitment to truth and transparency remains unshakeable amidst these constraints.

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On 21 July 2023, the Ministry of Communications and Information, under the leadership of Minister Josephine Teo, declared The Online Citizen Asia’s (TOC) website and social media platforms as Declared Online Locations (DOL) according to the Protection from Online Falsehoods and Manipulation Act 2019 (POFMA).

This decision follows a series of alleged false statements propagated by TOC, with the most recent incident reported on 2 May.

Amidst a politically charged environment characterized by scandals involving the People’s Action Party and increasing public mistrust towards the ruling government, TOC will continue to operate, albeit under significant constraints, despite the regulatory restrictions imposed.

The DOL declaration mandates that TOC must carry a public notice on its online platforms, which indicates its alleged history of disseminating misinformation.

The POFMA Office, however, clarified that TOC can continue its operations, retaining its website and social media pages under stringent regulations, particularly concerning monetization.

According to Part 5 of the POFMA, TOC is prohibited from gaining financial or material benefits from its operations. Additionally, offering financial support to TOC is equally unlawful. For the next two years, TOC will be compelled to self-sustain, relying solely on its resources without any public backing.

It strikes TOC as notably ironic that the Singapore government, eager to stymie our operations to prevent the spread of “fake news”, simultaneously demonstrates a fervour to invest S$900 million of taxpayer funds into the SPH Media Trust, currently embroiled in a data misrepresentation scandal. This dichotomy indeed presents a masterclass in cognitive dissonance.

Despite these significant constraints, TOC views this as an opportunity to revert to its roots, replicating the enthusiasm and drive that characterized our operation following our establishment in 2006.

Our existing staff will transition to a new publication, Gutzy Asia, focusing on news from Greater Asia, while TOC will refocus on its primary subject, Singapore, hence dropping the Asia subtext.

In this transition, we invite volunteers passionate about journalism and holding power to account to join us in our mission. We also welcome contributions from Singapore’s political parties, offering them a platform to express their perspectives and provide updates.

While this change may result in a decrease in content volume and frequency, we assure our supporters that our commitment to truth and transparency remains steadfast. We are legally obliged not to seek financial aid, but we hope our supporters will provide us with manpower and information support.

We are resolute in our decision to continue TOC’s operations, standing in defiance against attempts to silence dissent through lawsuits and intimidating regulations. We are here to serve the people, and we will continue our mission with determination and resilience.

To keep up to date with the publication: Follow The Online Citizen via telegram (Gutzy Asia’s posts are included)

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Editorial

Shanmugam, Balakrishnan, and the Code of Conduct: A Demand for Straight Answers

Editorial: Amid the recent controversy involving Singaporean ministers K Shanmugam and Vivian Balakrishnan regarding the tenancy of two state properties, serious questions have surfaced about potential breaches of the Ministerial Code of Conduct.

Despite being renowned for high standards of governance, the lack of a clear response from the ministers themselves and the decision to pass the issue to a review committee chaired by a fellow party member has raised eyebrows. The crucial question remains: does leasing property from the Singapore Land Authority, an organization overseen by the minister in question, breach the Code of Conduct?

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In a country renowned for its high standards of governance, the recent controversy surrounding the tenancy of two state properties by Minister K Shanmugam and Foreign Minister Vivian Balakrishnan has raised some perplexing questions.

Both ministers, tasked with the important responsibility of upholding the integrity of Singapore’s laws and foreign affairs, respectively, find themselves under scrutiny following allegations of a potential breach of the Ministerial Code of Conduct.

Mr Shanmugam claimed in his statement on Tuesday (23 May) to have “nothing to hide” and encouraged questions.

However, the irony is palpable when we consider the simple question that remains unanswered: Does leasing from the Singapore Land Authority (SLA), an organization he oversees, breach the Ministerial Code of Conduct?

Prime Minister Lee Hsien Loong’s decision to initiate a review is commendable and necessary to maintain the high standards of integrity that are a cornerstone of the Singapore government.

However, having a fellow People’s Action Party Senior Minister, Teo Chee Hean, chair the review does raise some questions. Furthermore, it remains puzzling why a straightforward answer isn’t forthcoming from the ministers implicated in this issue.

Under Section 3 of the Ministerial Code of Conduct, it’s stipulated that a Minister must avoid any actual or perceived conflict of interest between his office and his private financial interests.

While we should refrain from jumping to conclusions before the review concludes, the public certainly has the right to question whether a Minister leasing public property could conceivably conflict with his public duty.

This predicament reflects an unprecedented evasion of responsibility, particularly from Mr Shanmugam, who has been vocal in demanding clear and direct responses from political opponents.

Now that the tables have turned, the nation awaits his clear and direct answer – does leasing the property at 26 Ridout Road contravene the Code of Conduct for ministers?

Instead of a straightforward response, we see the matter deferred to a review committee and promises of addressing the issue in Parliament, where the ruling People’s Action Party holds a supermajority. This is far from the accountability and directness we expect from a Minister, especially one overseeing Law and Home Affairs.

The question is simple and direct, yet the absence of a clear answer has inevitably raised eyebrows and triggered skepticism about our leaders’ transparency and accountability. It is incumbent upon Mr Shanmugam and Mr Balakrishnan to clear the air and restore public confidence by providing a simple “Yes” or “No” answer.

Do the two ministers not think that the average person will likely perceive a conflict of interest when ministers rent from a government agency under the Law Minister’s purview? Once such a perception exists, how can there be no breach of Clause 3 of the Ministerial Code?

Clause 3, analogous to the maxim that justice must not only be done but seen to be done, requires a Minister to avoid actual conflict of interest and apparent or perceived conflict of interest.

Parliamentary privilege and safe environments shouldn’t be an excuse for evading direct answers. Singaporeans deserve more than opaque explanations and bureaucratic deferrals; they deserve straightforward, honest responses from their public servants. This is a matter of trust, transparency, and, above all, integrity.

If there’s anything the public can perceive from the actions of the ministers so far, it’s how out of touch they appear to be with common folks – both in the matter of principle and the need for accountability – from atop their massive ivory towers on Ridout Road.

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